AB1320 COVID-19 OUTCOME IN AN ITALIAN RHEUMATOID ARTHRITIS COHORT
Authors: E. Molteni, C. Castellani, G. Sciarra, L. Di Sanzo, G. Bevignani, M. Di Franco, V. Riccieri, C. Alessandri, R. Priori, F. Conti, R. Scrivo
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> It is known that rheumatologic patients often present a course of COVID-19 similar to that of the general population. Some factors are linked to a worse COVID-19 outcome, such as moderate glucocorticoid (GC) dose, high body mass index (BMI), and comorbidities. <h3>Objectives</h3> To describe the outcome of COVID-19 in patients with rheumatoid arthritis (RA) in terms of symptoms, therapy and need for hospitalization compared to a control group. Also, to evaluate the variation in disease activity before and after COVID-19. <h3>Methods</h3> In this monocentric prospective study, we recruited consecutive adult patients with RA classified according to ACR-EULAR 2010 criteria who received a diagnosis of COVID-19 through molecular or rapid antigen swab tests between September 2020 and December 2022. Demographic and clinical data, including age, BMI, smoking habit, comorbidities, treatment at the diagnosis of COVID-19, duration of COVID-19, symptoms related to the infection and therapy required, together with the vaccination status were collected through a self-administered questionnaire. We compared DAS28-CRP before the infection and at the first visit after the resolution. As controls (Cs), individuals with COVID-19 but with no referred diagnosis of rheumatic/autoimmune disease were recruited. <h3>Results</h3> We enrolled 111 patients affected by RA (males 15%, median age 56 years, IQR 25) and 89 Cs (males 44%, median age 47 years, IQR 43), whose demographic and clinical characteristics are reported in <b>Table 1</b>. The median RA disease duration was 108 months (IQR 201). At the COVID-19 diagnosis, 62 patients (56%) were assuming csDMARDs, 67 (60%) bDMARDs, and 18 (16%) GC with a median prednisone equivalent dose of 4 mg/day (IQR 1). DAS28-CRP was available for 62 patients, with a median value of 1.67 (IQR 2.71); 42 patients (60%) were in remission (Figure 1). Before developing COVID-19, only 35 (32%) RA patients and 42 (47%) Cs had completed the vaccinal cycle, which was performed by mRNA vaccine in all the patients and 87% of Cs. The median COVID-19 duration was 18 days (IQR 18) for RA patients and 14 days (IQR 13.5) for Cs (p&gt;0.7). Cs reported a significantly higher frequency of constitutional symptoms (headache and asthenia) compared to RA patients (p&lt;0.00001). When hospitalization was required, RA patients received heparin more frequently than Cs (p&lt;0.039). Once COVID-19 was resolved, RA patients were evaluated after a median of 2 months (IQR 2). DAS28-CRP was available for 68 patients, with a median value of 1.61 (IQR 1.77); 42 patients (68%) were in remission (Figure 1). No differences in terms of COVID-19 duration, clinical manifestations, and therapy emerged comparing RA patients in remission (40; 58%) with patients with the active disease before COVID-19 (29; 42%). Also, in vaccinated subjects, the outcome of COVID-19 was similar in RA patients and Cs, irrespective of RA activity. <h3>Conclusion</h3> COVID-19's impact on patients with RA was not significantly different from the general population, even for patients with active RA. Patients did not suffer from reactivation of RA because of COVID-19. In our opinion, these positive results could be ascribed to the massive vaccination campaign. <h3>References</h3> [1]Conway R et al, Ir J Med Sci. 2023 [2]Andersen KM et al, Lancet Rheumatol. 2022 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.